Insurers paying cash bounties if you seek out cheaper health care


No matter how the Supreme Court rules in June on President Obama’s health care reform, the reality is we’re spending too much of our nation’s resources on health care. And we don’t have the longevity and health of other countries that spend half of what we do!

I believe the core of the problem is that we as patients are not the customer. The customer is instead a large employer, a health insurer or even the federal or state government. So we are not connected directly — unless we have no insurance — to the provision of health care and what it costs.

In a new move, there are experiments in New Hampshire, Connecticut and Indiana where insurers are actually offering cash bounties if you use a lower-cost facility or provider. I love this idea!

What we have right now is a system that is fundamentally broken because the consumer is not given incentives to be a consumer. Until we reconnect health care with us having a stake in how it’s paid and what’s paid, we won’t get anywhere with health care reform in the U.S.

That’s why one of my fundamental beliefs is the health care should be individualized completely, meaning it should not be provided through an employer or through the government. In my ideal world, you and I would be responsible for buying our own policies. The poor and elderly would get a subsidy like a voucher to defray the cost of buying their policy.

But as interim step, I like the experiment in those three states I mentioned. Finally people are being given a direct incentive to save money.

Years ago, there was an insurer that experimented with a red/yellow/green system for non-emergency care. You would go on their website and the provider that was the most affordable for you would come up green; a more expensive provider would be yellow; and a provider who was really expensive would be red.

Simple marketplace economics helping you become a customer in health care, right? Unfortunately, red/yellow/green didn’t catch on.

We still need a system in America where we make decisions about buying our health care, just as we would when deciding where to eat or what fridge or TV to buy. Cost/quality comparisons are needed so we can control the future costs of health care in our nation.

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